MBS item 73457 ===== Whole genome or exome/mitochondrial DNA sequencing for patients with suspected mitochondrial disease, including parents' samples, requested by specialist with clinical indicators present, not previously funded under related items. Category 6 · Pathology services[Group P7](/groups/P7) Schedule fee$3,300.00 100% benefitGP, out of hospital— 85% benefitOut of hospital$3,195.50 75% benefitIn hospital$2,475.00 The schedule fee for MBS item 73457 is $3,300.00. Medicare pays $3,195.50 (85%) out of hospital, or $2,475.00 (75%) for a privately admitted patient in hospital. Fee effective 1 November 2023. Gap for what you charge ----------------------- Your fee$ Out of hospitalIn hospital (private) Medicare pays$3,195.50 Patient gap$104.50 Bulk billing means accepting $3,195.50 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=73457) Item descriptor --------------- Characterisation by whole genome sequencing, or either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA, of a patient with a strong suspicion of a mitochondrial disease, if: (a) the characterisation is performed using a sample from the patient and a sample from each of the patient’s biological parents; and (b) the request for the characterisation states that singleton testing is inappropriate; and (c) the characterisation is requested by a specialist or consultant physician; and (d) the characterisation is requested because of the onset of one or more clinical features indicative of mitochondrial disease, including at least one or more of the following: (i) meeting the clinical criteria of a probable indicator of mitochondrial disease on a relevant scoring system; (ii) evident mitochondrial dysfunction or decompensation; (iii) unexplained hypotonia or weakness, profound hypoglycaemia or “failure to thrive” in the presence of a metabolic acidosis; (iv) unexplained single or multi-organ dysfunction or fulminant failure (including, but not limited to, neuropathies, myopathies, hepatopathy, pancreatic and/or bone marrow failure); (v) refractory or atypical seizures, developmental delays or cognitive regression, or progressive encephalopathy or progressive encephalomyopathy; (vi) cardiomyopathy and/or cardiac arrythmias; (vii) rapid hearing or painless visual loss or ptosis; (viii) stroke-like episodes or nonvasculitic strokes; (ix) ataxia, encephalopathy, seizures, muscle fatigue or weakness; (x) external ophthalmoplegia; (xi) hearing loss, diabetes, unexplained short stature, or endocrinopathy; (xii) family history of mitochondrial disease; and (e) the service is not a service associated with a service to which item 73358, 73359 or 73456 applies Applicable only once per lifetime [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=73457) Health fund and DVA rates ------------------------- Total fee each scheme recognises for this item in hospital. StateNSWVICQLDSAWATASACTNT Guides ------ - [How Medicare benefits work: schedule fees, 75%, 85% and 100%](/guides/how-medicare-benefits-work) - [Medicare safety nets explained: original and extended (EMSN) thresholds for 2026](/guides/medicare-safety-nets) - [In-hospital billing: the 75% benefit, the 25% fund benefit, and no-gap and known-gap schemes](/guides/in-hospital-billing-and-gap-cover) - [Bulk billing incentives and BBPIP explained: 2026 amounts by MM area](/guides/bulk-billing-incentives) - [The MBS multiple operation rule and surgical assistant fees](/guides/multiple-operation-rule) - [Assignment of benefit for bulk billing: the changes from 1 July 2026](/guides/assignment-of-benefit-2026) - [MBS telehealth rules: the eligible telehealth practitioner and phone items](/guides/mbs-telehealth-rules) - [GP chronic condition management plans: items 965 and 967 explained](/guides/chronic-condition-management-plans) - [Medicare billing compliance: claim time limits, records and the 80/20 rule](/guides/medicare-billing-compliance) Data source: [Australian Government Medicare Benefits Schedule](https://www.mbsonline.gov.au/) · Record updated 1 September 2026. Health fund rates come from each fund's published schedule. Verify item descriptors, rules and fees on [MBS Online](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=73457) before billing. This is a reference tool, not billing or financial advice.